title: Second trimester maternal serum inhibin-A in fetal anemia secondary to hemoglobin Bart's disease.
abstract: OBJECTIVE
  To compare the levels of inhibin-A between pregnancies with fetal anemia secondary to Hb Bart's disease and pregnancies with normal non-anemic fetuses.
  
  
  METHODS
  Sixty-five pregnancies at risk of fetal Hb Bart's disease scheduled for cordocentesis at 18-22 weeks were prospectively recruited into the study. Inhibin-A levels were measured from maternal blood drawn before cordocentesis. Fetal blood samples were collected for fetal Hb typing and hemoglobin (Hb) levels.
  
  
  RESULTS
  Maternal serum inhibin-A was significantly higher in women with fetal Hb Bart's disease than those with unaffected fetuses (1.03 MoM (multiple of median) and 0.75 MoM, respectively, p = 0.001). The relationship between maternal serum inhibin-A and fetal Hb level was a quadratic equation; inhibin-A = 5.248 - 9.415(Hb) + 4.919(Hb)(2) (r(2) = 0.274, p < 0.001). Maternal serum inhibin-A did not correlate with cardiomegaly but was significantly associated with placental thickness; inhibin-A = 1.372 - 0.751(Pl) + 0.214(Pl)(2) (r(2) = 0.237, p = 0.007).
  
  
  CONCLUSIONS
  Maternal serum inhibin-A levels were significantly higher in pregnancies with fetal Hb Bart's disease. The elevation of inhibin-A was likely to be a consequence of fetal anemia and placentomegaly. Since inhibin-A is commonly used as a component of quadruple test; the calculated risk of Down's syndrome may be unreliable in pregnancies with fetal Hb Bart's disease or possible fetal anemia.
authors.affiliation: Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University , Chiang Mai , Thailand.
authors.forename: Fuanglada
authors.initials: F
authors.lastname: Tongprasert
authors.forename: Kasemsri
authors.initials: K
authors.lastname: Srisupundit
authors.forename: Suchaya
authors.initials: S
authors.lastname: Luewan
authors.forename: Theera
authors.initials: T
authors.lastname: Tongsong
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D017218:Cordocentesis; D005260:Female; D005312:Fetal Blood / Q000737:chemistry / Q000378:metabolism; D005315:Fetal Diseases / Q000097:blood* / Q000175:diagnosis; D006455:Hemoglobins, Abnormal; D006801:Humans; D007265:Inhibins / Q000097:blood*; D062145:Maternal Serum Screening Tests; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000097:blood*; D011446:Prospective Studies; D017085:alpha-Thalassemia / Q000097:blood* / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D006455:Hemoglobins, Abnormal; C422362:inhibin A; D007265:Inhibins; C030448:hemoglobin Bart's
keywords: Fetal anemia; hemoglobin Bart’s disease; homozygous alpha-thalassemia-1 disease; inhibin-A; maternal serum marker